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Annals of Laboratory Medicine Sep 2023Delta checks increase patient safety by identifying automated hematology analyzer errors. International standards and guidelines for the complete blood count (CBC) delta...
BACKGROUND
Delta checks increase patient safety by identifying automated hematology analyzer errors. International standards and guidelines for the complete blood count (CBC) delta check method have not been established. We established an effective, practical CBC delta check method and criteria.
METHODS
We assessed five delta check methods for nine CBC items (Hb, mean corpuscular volume, platelet count, white blood cell [WBC] count, and five-part WBC differential counts) using 219,804 blood samples from outpatients and inpatients collected over nine months. We adopted the best method and criteria and evaluated them using 42,652 CBC samples collected over two weeks with a new workflow algorithm for identifying test errors and corrections for Hb and platelet count.
RESULTS
The median delta check time interval was 1 and 21 days for inpatients and outpatients (range, 1-20 and 1-222 days), respectively. We used delta values at 99.5% as delta check criteria; the criteria varied among the five methods and between outpatients and inpatients. The delta percent change (DPC)/reference range (RR) rate performed best as the delta check for CBC items. Using the new DPC/RR rate method, 1.7% of total test results exceeded the delta check criteria; the retesting and resampling rates were 0.5% and 0.001%, respectively.
CONCLUSIONS
We developed an effective, practical delta check method, including RRs and delta check time intervals, and delta check criteria for nine CBC items. The criteria differ between outpatients and inpatients. Using the new workflow algorithm, we can identify the causes of criterion exceedance and report correct test results.
Topics: Humans; Blood Cell Count; Leukocyte Count; Platelet Count; Quality Control; Hematology
PubMed: 37080742
DOI: 10.3343/alm.2023.43.5.418 -
The Journal of International Medical... Sep 2021I investigated whether the platelet distribution width/platelet count (PDW/PC) ratio, which is an inexpensive and simple test performed for almost all patients, is...
OBJECTIVE
I investigated whether the platelet distribution width/platelet count (PDW/PC) ratio, which is an inexpensive and simple test performed for almost all patients, is applicable in the follow-up of patients with Hashimoto's thyroiditis and examined the relationship of this ratio with thyroperoxidase and thyroglobulin antibody levels.
MATERIALS AND METHODS
The study groups consisted of 67 patients with Hashimoto's thyroiditis and 17 controls. All participants were aged 20 to 75 and treated the Internal Medicine outpatient clinic of my institution. The PDW/PC ratio and thyroid antibody levels were retrospectively evaluated in patients with normal liver and renal function and normal white blood cell counts, hemoglobin levels, and hematocrit levels.
RESULTS
Thyroid antibody levels were significantly higher in patients with Hashimoto's thyroiditis than in controls. PC was higher in patients with Hashimoto's thyroiditis, whereas the PDW/PC ratio was lower. However, these differences were not statistically significant.
CONCLUSION
In this study, I did not find a statistically significant relationship between thyroid antibody levels and PDW/PC. However, a weak correlation between these variables was identified.
Topics: Hashimoto Disease; Humans; Platelet Count; Retrospective Studies; Thyroglobulin
PubMed: 34586923
DOI: 10.1177/03000605211043241 -
Revista Da Associacao Medica Brasileira... 2023This study aimed at investigating whether there is a relationship between 7- or 30-day mortality and mean platelet volume, platelet distribution width, platelet...
OBJECTIVE
This study aimed at investigating whether there is a relationship between 7- or 30-day mortality and mean platelet volume, platelet distribution width, platelet count-to-total lymphocyte count ratio, or red cell distribution width in patients with traumatic brain injury.
METHODS
We retrospectively analyzed intensive care unit patients with traumatic brain injury. We recorded patients' ages; genders; diagnoses; Glasgow Coma Scale scores; length of intensive care unit stay (in days); mean platelet volume, platelet distribution width, platelet count-to-total lymphocyte count ratio, and red cell distribution width values upon hospital admission; and health on the 7th and 30th days of their stays.
RESULTS
We analyzed data from 110 patients. Of these, 84 (76.4%) were male and 26 (23.6%) were female. On the 7- and 30-day mortality evaluations, compared to the living patients, the deceased patients had a significantly higher median age and a significantly lower median Glasgow Coma Scale. Thus, increased age and lower Glasgow Coma Scale scores were associated with increased 7- and 30-day mortality rates. mean platelet volume and platelet distribution width values were similar in living and deceased patients. platelet count-to-total lymphocyte count ratio values were lower in deceased patients, but this difference was not statistically significant. Within 30 days after traumatic brain injury, deceased patients' red cell distribution width values were significantly elevated in deceased patients compared to those of living patients.
CONCLUSION
Mean platelet volume, platelet distribution width, and platelet count-to-total lymphocyte count ratio values were not associated with 7- and 30-day mortality, whereas only elevated red cell distribution width was associated with 30-day mortality.
Topics: Humans; Male; Female; Erythrocyte Indices; Retrospective Studies; Mean Platelet Volume; Platelet Count; Brain Injuries, Traumatic
PubMed: 36820710
DOI: 10.1590/1806-9282.00210889 -
Blood Jul 1988Recent studies on platelet heterogeneity support the hypothesis that platelet production is regulated to maintain a constant functional platelet mass. In concept this... (Review)
Review
Recent studies on platelet heterogeneity support the hypothesis that platelet production is regulated to maintain a constant functional platelet mass. In concept this form of regulation is analogous to the manner by which RBC production is controlled to maintain the oxygen-carrying capacity of blood. The platelet mass appears to correlate more closely with platelet function than the platelet count alone, since several factors in addition to the platelet count have been shown to influence the platelets' hemostatic function. These factors include platelet size, density, age, and previous hemostatic interactions. Application of these concepts to clinical problems has provided important insights into platelet physiology and reactivity. Failure to account for differences in platelet heterogeneity among individuals may introduce significant errors in the interpretation of data from laboratory and clinical investigations. However, despite advances, a number of practical issues remain to be resolved before measurements of platelet heterogeneity become accepted as routine clinical tests and are used in the diagnosis of pathologic states.
Topics: Animals; Blood Platelets; Cell Survival; Humans; Platelet Count
PubMed: 3291975
DOI: No ID Found -
Medicine Sep 2023Fractures of the distal radius are a common fracture with an increasing incidence. However, the underlying factors for distal radius fractures (DRFs) remain unclear. A...
Fractures of the distal radius are a common fracture with an increasing incidence. However, the underlying factors for distal radius fractures (DRFs) remain unclear. A total of 123 patients with distal radial fractures were recruited. To document clinical and follow-up data, and measure the levels of white blood cells, hemoglobin, platelets, and red blood cells in the bloodstream for qualitative observation of their expression effects within the human body, specifically assessing whether the magnitudes of these indicators are associated with potential factors influencing DRF. Pearson chi-square test and Spearman correlation were used to analyze the relationship between DRF and related parameters. Univariate and multivariate logistic regression and multivariate Cox proportional risk regression were used for further analysis. Pearson chi-square test and Spearman correlation analysis showed a significant correlation between platelet and red blood cell levels and the occurrence of DRFs. Univariate logistic regression analysis demonstrated a significant correlation between platelet count (OR [odds ratio] = 6.286, 95% CI [confidence interval]: 2.862-13.808, P < .001) and red blood cell count (OR = 2.780, 95% CI: 1.322-5.843, P = .007) with DRFs. Increasing levels of both indicators were associated with a higher susceptibility to DRFs. Multivariate logistic regression showed that platelets (OR = 6.344, 95% CI: 2.709-14.855, P < .001) were significantly associated with DRFs. Multivariate Cox regression analysis showed sex (HR [hazard ratio] = 0.596, 95% CI: 0.381-0.931, P = .023) and platelet (HR = 3.721, 95% CI: 2.364-5.855, P < .001) were significantly associated with maintenance time from recovery to recurrence (MTRR) of DRFs. In other words, the platelet content in the body of different genders is different, and the MTRR of DRF is different. Platelets were significantly associated with DRFs. The higher the platelet count, the higher the risk of DRF and the shorter the time of DRF recurrence.
Topics: Humans; Female; Male; Blood Platelets; Wrist Fractures; Platelet Count; Prognosis; Fractures, Bone
PubMed: 37682171
DOI: 10.1097/MD.0000000000035043 -
Liver Transplantation : Official... Apr 2011
Topics: Adult; Hepatectomy; Humans; Liver Regeneration; Liver Transplantation; Living Donors; Platelet Count
PubMed: 21445917
DOI: 10.1002/lt.22277 -
American Family Physician Sep 1999HELLP, a syndrome characterized by hemolysis, elevated liver enzyme levels and a low platelet count, is an obstetric complication that is frequently misdiagnosed at... (Review)
Review
HELLP, a syndrome characterized by hemolysis, elevated liver enzyme levels and a low platelet count, is an obstetric complication that is frequently misdiagnosed at initial presentation. Many investigators consider the syndrome to be a variant of preeclampsia, but it may be a separate entity. The pathogenesis of HELLP syndrome remains unclear. Early diagnosis is critical because the morbidity and mortality rates associated with the syndrome have been reported to be as high as 25 percent. Platelet count appears to be the most reliable indicator of the presence of HELLP syndrome. The D-dimer test may be a useful tool for the early identification of patients with preeclampsia who may develop severe HELLP syndrome. The mainstay of therapy is supportive management, including seizure prophylaxis and blood pressure control in patients with hypertension. Women remote from term should be considered for conservative management, whereas those at term should be delivered. Some patients require transfusion of blood products, and most benefit from corticosteroid therapy. Rarely, patients with refractory HELLP syndrome require plasmapheresis.
Topics: Diagnosis, Differential; Female; HELLP Syndrome; Humans; Patient Education as Topic; Platelet Count; Pregnancy; Prognosis; Teaching Materials
PubMed: 10498110
DOI: No ID Found -
Archivos Argentinos de Pediatria Aug 2021Non-immune thrombocytopenia is caused by multiple pathologies; the most common causes are extra- or intrauterine infections, whereas secondary cases result from other... (Review)
Review
Non-immune thrombocytopenia is caused by multiple pathologies; the most common causes are extra- or intrauterine infections, whereas secondary cases result from other pathologies involved in the fetal-placentalmaternal interface. This second article lists its causes and provides details of the different pathologies. Platelet transfusion is widely used in neonatology, both as treatment and as bleeding prophylaxis. However, there is no general consensus about the platelet count threshold that is convenient to indicate a transfusion or actual indications. Recent articles are commented regarding the different proposed strategies. The emphasis is on discussing the multiple adverse effects of platelet transfusions because knowledge about them is changing the paradigm for indications, suggesting that a much more restrictive policy is required.
Topics: Hemorrhage; Humans; Infant, Newborn; Neonatology; Platelet Count; Platelet Transfusion; Thrombocytopenia, Neonatal Alloimmune
PubMed: 34309308
DOI: 10.5546/aap.2021.eng.e303 -
Acta Veterinaria Scandinavica Dec 2021Primary immune thrombocytopenia (ITP) is a cause of severe thrombocytopenia in dogs. Immunosuppressive corticosteroid drugs are frequently used in the management of ITP,... (Review)
Review
Primary immune thrombocytopenia (ITP) is a cause of severe thrombocytopenia in dogs. Immunosuppressive corticosteroid drugs are frequently used in the management of ITP, but treatment failure may occur. Immunomodulatory and non-corticosteroid immunosuppressive drugs might improve outcomes from therapy either alone or in combination with corticosteroids. The objectives of this scoping review were (1) to evaluate the current evidence relating to immunomodulatory and immunosuppressive drug protocols in the treatment of canine ITP, and (2) to answer the clinical question, whether or not therapy with immunomodulatory or non-corticosteroid immunosuppressive drugs alone or in combination with corticosteroids could improve outcome, compared to therapy with corticosteroids alone. A literature search was performed in the electronic databases of Agricola, CAB Abstracts, Embase, Medline and Web of Science for publications in November 2019 and again February 1, 2021. Selection criteria were relatively strict and included peer-reviewed research papers reporting outcome measures from immunomodulatory and immunosuppressive drug protocols in the treatment of canine ITP with a pre-therapeutic mean or median platelet count < 50,000/µL as a strict criterion for inclusion. Studies were evaluated if they had an appropriate diagnostic work up to exclude underlying conditions. Outcome measures and adverse events were compared between drug protocols both within studies and between studies. The search identified 456 studies, with six studies being eligible for inclusion. The studies were mostly case series while two were randomized controlled trials. Level of evidence varied with an overall uncertain subject enrollment, small groups, inadequate description and variable use of drug protocols or outcome measures. For outcomes such as platelet recovery time and duration of hospitalization, an improvement was observed using adjunctive therapy (human intravenous immunoglobulin) compared to therapy with corticosteroids alone. For outcomes of complete platelet recovery time, survival (6-month), mortality and relapse, no improvement was observed using adjunctive drugs compared to corticosteroids alone. Specifically, therapy with mycophenolate mofetil alone and adjunctive azathioprine were associated with more severe adverse events compared to other drug protocols. Evidence relating to immunomodulatory and immunosuppressive drug protocols in the treatment of canine ITP was of variable quality. Future larger case-controlled trials are required for determination of optimal treatment protocols in canine ITP.
Topics: Animals; Blood Platelets; Dog Diseases; Dogs; Immunosuppressive Agents; Pharmaceutical Preparations; Platelet Count; Purpura, Thrombocytopenic, Idiopathic
PubMed: 34961516
DOI: 10.1186/s13028-021-00620-z -
Journal of Orthopaedic Surgery and... Apr 2022The diagnostic value of platelet indices has been evaluated in various infectious diseases but not in infected nonunion. The purpose of this study was to assess the...
BACKGROUND
The diagnostic value of platelet indices has been evaluated in various infectious diseases but not in infected nonunion. The purpose of this study was to assess the usefulness of platelet indices for diagnosis of infected nonunion after open reduction and internal fixation.
METHODS
This retrospective study was performed in patients who underwent primary fracture nonunion revision surgeries from January 2016 to December 2021. A total of 297 patients were included in the study: 96 with infected nonunion (group A) and 201 with aseptic nonunion (group B). Receiver operator characteristic (ROC) curve analysis was performed to evaluate diagnostic value of each index. Area under the curve (AUC), sensitivity, specificity, and positive and negative predictive values were calculated and compared.
RESULTS
Demographic characteristics were comparable between the two groups. White blood cell (WBC) count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), plasma fibrinogen, plasma D-dimer, platelet count (PC), plateletcrit, and ratio of platelet count to mean platelet volume (PC/MPV) were significantly higher, and MPV and platelet distribution width (PDW) significantly lower, in group A than in group B (P < 0.05). ROC analysis showed PC/MPV and plasma fibrinogen to have better diagnostic value than the other coagulation indicators (AUC of 0.801 and 0.807, respectively). The combination of ESR, plasma fibrinogen, and PC/MPV had good sensitivity and specificity for diagnosis of infected nonunion. PC/MPV had better diagnostic value than ESR and plasma fibrinogen in the subgroup of patients with coagulation-related comorbidities.
CONCLUSIONS
Plasma fibrinogen and PC/MPV ratio might be useful parameters for early diagnosis of infected nonunion.
Topics: Area Under Curve; Blood Sedimentation; Humans; Mean Platelet Volume; Platelet Count; Retrospective Studies
PubMed: 35379285
DOI: 10.1186/s13018-022-03096-3